
<%@ taglib prefix="spring" uri="http://www.springframework.org/tags" %>
<%@ taglib prefix="form" uri="http://www.springframework.org/tags/form" %>

<br/>

<h3>
Physician Screen:
</h3>

<form:form modelAttribute="physician" action="addPhysician.do">
  <table>
        			
    <tr>
      <td>
        Id: <form:errors path="id" cssClass="errors"/>
      </td>
      <td>
        <form:input path="id" />
      </td>
    </tr>
			
    <tr>
      <td>
        FirstName: <form:errors path="firstName" cssClass="errors"/>
      </td>
      <td>
        <form:input path="firstName" />
      </td>
    </tr>
			
    <tr>
      <td>
        MiddleName: <form:errors path="middleName" cssClass="errors"/>
      </td>
      <td>
        <form:input path="middleName" />
      </td>
    </tr>
			
    <tr>
      <td>
        LastName: <form:errors path="lastName" cssClass="errors"/>
      </td>
      <td>
        <form:input path="lastName" />
      </td>
    </tr>
			
    <tr>
      <td>
        Address1: <form:errors path="address1" cssClass="errors"/>
      </td>
      <td>
        <form:input path="address1" />
      </td>
    </tr>
			
    <tr>
      <td>
        Phone: <form:errors path="phone" cssClass="errors"/>
      </td>
      <td>
        <form:input path="phone" />
      </td>
    </tr>
			
    <tr>
      <td>
        Email: <form:errors path="email" cssClass="errors"/>
      </td>
      <td>
        <form:input path="email" />
      </td>
    </tr>
			
    <tr>
      <td>
        FaxNumber: <form:errors path="faxNumber" cssClass="errors"/>
      </td>
      <td>
        <form:input path="faxNumber" />
      </td>
    </tr>
			
    <tr>
      <td>
        OfficeContact1: <form:errors path="officeContact1" cssClass="errors"/>
      </td>
      <td>
        <form:input path="officeContact1" />
      </td>
    </tr>
			
    <tr>
      <td>
        Address2: <form:errors path="address2" cssClass="errors"/>
      </td>
      <td>
        <form:input path="address2" />
      </td>
    </tr>
			
    <tr>
      <td>
        OfficeContact2: <form:errors path="officeContact2" cssClass="errors"/>
      </td>
      <td>
        <form:input path="officeContact2" />
      </td>
    </tr>
			
    <tr>
      <td>
        Speciality: <form:errors path="speciality" cssClass="errors"/>
      </td>
      <td>
        <form:input path="speciality" />
      </td>
    </tr>
			
    <tr>
      <td>
        Degree: <form:errors path="degree" cssClass="errors"/>
      </td>
      <td>
        <form:input path="degree" />
      </td>
    </tr>
			
    <tr>
      <td>
        YearsOfExperience: <form:errors path="yearsOfExperience" cssClass="errors"/>
      </td>
      <td>
        <form:input path="yearsOfExperience" />
      </td>
    </tr>
			
    <tr>
      <td>
        MonthlyCommitment: <form:errors path="monthlyCommitment" cssClass="errors"/>
      </td>
      <td>
        <form:input path="monthlyCommitment" />
      </td>
    </tr>
			
    <tr>
      <td>
        SubsidizedTest: <form:errors path="subsidizedTest" cssClass="errors"/>
      </td>
      <td>
        <form:input path="subsidizedTest" />
      </td>
    </tr>
			
    <tr>
      <td>
        ServicesProvided: <form:errors path="servicesProvided" cssClass="errors"/>
      </td>
      <td>
        <form:input path="servicesProvided" />
      </td>
    </tr>
			
    <tr>
      <td>
        LabServices: <form:errors path="labServices" cssClass="errors"/>
      </td>
      <td>
        <form:input path="labServices" />
      </td>
    </tr>
			
    <tr>
      <td>
        RegistrationId: <form:errors path="registrationId" cssClass="errors"/>
      </td>
      <td>
        <form:input path="registrationId" />
      </td>
    </tr>
			

	<tr>
    	<td colspan="2">
 			<input type="submit" value="Save Changes" />
        </td>
	</tr>

  </table>
</form:form>

	